LOS ANGELES — Roughly 50 million people are under quarantine in China. Thousands of travelers are being screened at airports every day. Armies of disease detectives are knocking on doors around the world in hopes of halting the new coronavirus in its tracks.
Despite all the colossal efforts to contain the virus, scientists are quietly preparing for a grim — and increasingly likely — outcome: A full-blown global pandemic.
Since the novel virus was isolated in December in the Chinese megacity of Wuhan, the pathogen has reached four continents and infected more than 24,000 people. At least 493 of them have died as a result. With the outbreak continuing to expand, authorities acknowledge that efforts will soon shift from trying to squelch the coronavirus to learning to live with it.
“We’re proceeding as if things go really sour on us in the coming weeks and months,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “We’re working for the worst-case scenario.”
The World Health Organization raised the stakes last week by declaring a public health emergency of international concern. The Trump administration responded by proclaiming a public health emergency in the United States, restricting incoming flights from China and ordering the country’s first mandatory quarantine in more than 50 years.
Yet the outbreak shows no signs of slowing down.
Infectious disease experts at Imperial College London have calculated that each person infected with the virus early in the outbreak spread it to 2.6 others, on average. For the sake of comparison, in the early days of the 1918 Spanish flu outbreak, each person who became sick is thought to have infected 1.8 others.
Lab-confirmed cases of coronavirus have increased more than 300-fold in the last three weeks. And while two-thirds of early cases were linked to a single market, that proportion quickly dropped, suggesting human-to-human transmission is widespread. Researchers believe individual epidemics are already self-sustaining in several major Chinese cities, and could appear around the globe in regions where travelers from China arrived before showing any symptoms of illness.
“Containment is an increasingly remote possibility,” said Dr. Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, or CEPI, which is coordinating work on a vaccine for 2019-nCoV. “This is not a China problem. It’s a global problem.”
And although the overwhelming majority of those infected so far have recovered, it’s certainly possible that the virus could become more dangerous.
“The nightmare scenario here is if it mutates into a highly pathogenic strain,” said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law. “These kinds of viruses are very adaptable and can swap genes to become much more lethal. We can’t be complacent.”
Health officials aren’t waiting around to see if that will happen. Their preparations for sustained global spread of the coronavirus are already underway.
For starters, doctors and epidemiologists will need reliable, rapid diagnostic tests that can distinguish between people who have influenza or pneumonia and those who are infected with the new virus. That would help ensure patients get the appropriate treatment and allow health officials to map the outbreak accurately.
The Centers for Disease Control and Prevention has already created a test based on the coronavirus genome shared by Chinese scientists and used it to confirm the 11 cases in the U.S., said Dr. Nancy Messonnier, director of the agency’s National Center for Immunization and Respiratory Diseases.
But in a pandemic scenario, that test won’t cut it. Doctors will need a faster, simpler tool that’s as easy to use as a pregnancy test or a rapid strep test. Otherwise they’ll struggle to keep up with the throngs of people who could turn up in emergency rooms and medical clinics with pneumonia-like symptoms. So far, no companies appear to be working on such a test for 2019-nCoV.
Doctors would also need easy access to medicines that can treat the novel coronavirus. Physicians on the front lines have been testing several antiviral drugs that are used for diseases like HIV and Ebola, and researchers are tracking their effectiveness.
